Aging up and Aging In – Perspectives from the Sandwich Generation

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For those with children aging up to adult health care and parents aging in to Medicare, trying to ensure your loved ones’ health care needs are met can be time-consuming and confusing. This group of middle-aged adults caring for both elderly parents and dependent children is often called “the sandwich generation.”

Lara McKenna, executive director of business and patient relations at Edinger Medical Group, recalls when she first heard that term.  “I was a struggling mom with children getting ready to go to college and parents who were aging, and I became one of their primary caregivers. I was dealing with in-home living assistance, helping them choose alternative health-care and reconciling their medications.

“It was almost overwhelming,” McKenna says. “But hearing and defining that simple term — sandwich generation — made me feel like I wasn’t the only person living in this.”

McKenna, a 29-year employee of Edinger Medical Group, says planning ahead, doing research and having conversations with your loved ones about their health care needs can take the fear and confusion out of the process.

Helping your kids age up to adult care

If your child is about to turn 18, that’s the time to start thinking about reassigning them from a pediatrician to an adult physician. Often,  that time comes when your child needs to get a college physical. Typically, McKenna says, once they get through that they start to realize they can do this on their own.

“Especially now that we’ve come into the digital age, patients, especially our young patients, can schedule their appointments online, they can text message us — all those things can happen in their preferred communication, which is really adaptable to that age, so that’s helpful for us and for them.”

The aging-up process must start with the parents, McKenna says. The best approach is to talk with your child about privacy and what can happen in a medical emergency.

“Explain to your child that once you’re 18 you are now considered an adult, and people aren’t going to talk to your parents, especially when it comes to your health and privacy. If you can engage with an 18-year-old on that level, it can open up so much more about  what are some of your boundaries or your expectations now that you’re 18.”

For McKenna, that conversation happened when her daughter, and later her son, was about to leave home to go to college. “You start to realize that as a parent, your hands could be tied if something happens to them.”

McKenna suggests establishing in advance with your child whether, as a parent, you are allowed to have information on their health care if they’re away at school and whether you are allowed to send a message to their doctor — or would they be more comfortable doing things their own?

She  notes that if you don’t make a decision on transitioning your child to an adult physician, your health plan will make it for you. “It’s really important that parents, and the child now getting information on behalf of the insurance provider, pay attention. Because if it’s an emergency situation, your child could suddenly be going to a hospital or a doctor that you have no coverage for.”

Helping your parents age in to Medicare

Likewise, having discussions with your aging parents is just as important to ensure the Medicare plan they choose is right for them. Some seniors are on the road a lot,  and they might prefer a traditional plan over a Medicare Advantage plan. For others, such as McKenna’s mother who grew tired of paying out of pocket, they appreciate an Advantage plan that covers pharmacy, hospital and doctor visits.

McKenna helped her mom transition to a Medicare SCAN plan. “She knew what she was paying for when she went,” she says.

Edinger is one of the few medical groups in Orange County that has earned a five-star rating with Integrated Health Association (IHA) for the quality of care for Medicare Advantage patients.

Edinger recently earned IHA’s Excellence in Healthcare Award for the 17th consecutive year, making it a great choice for both your young adults’ and aging parents’ health care needs.

“It takes a community,” McKenna says. “It’s not just one doctor, one medical assistant, one nurse practitioner; it’s Edinger collaboratively, which means everyone’s got to be rowing the same way, providing care the same way.”

First steps

When helping a parent age in, start by doing your research, McKenna says.  “It’s so easy to be confused, and things like making a change on the plan at the wrong time of year or joining a part of a plan you don’t know much about could negate your benefits,” she says.

Edinger offers senior care coordinators who can provide referrals to no-fee brokers who will do a side-by-side plan comparison. So, even if it’s not a plan Edinger takes, Edinger wants it to be better for the patient, not better for Edinger, McKenna explains.

She suggests looking for those kind ears who can offer advice, whether that’s your insurance broker, friends or family members. But start with your parents’ physician, who can point you in the right direction.

It’s also crucial to give yourself a little grace, McKenna says. “You are truly being tugged in two directions. You have to speak up and get people to hear.”